Wednesday, March 18, 2009

Rhoads: Less Government, Not More

Jared Rhoads, director of the Lucidicus Project, has written another excellent OpEd on the problems with Massachusetts' health care. Some critics of the Massachusetts system are using that failure to call for yet more government control of health care. Rhoads notes that the exact opposite is true.

Recently, a national organization of physicians released a report strongly criticizing the health reform effort in Massachusetts that imposes a mandate on residents to purchase health insurance.[1] Citing several studies and data sources, the group showed that the reform has added wasteful new layers of bureaucracy and has failed to control costs. The Massachusetts program, they said, is faltering badly and thus should not be held up as a national model for reform.

Not exactly a ringing endorsement of government intervention in health insurance, right?

Think again. The report was published by Physicians for a National Health Plan (PNHP), a group that exists specifically to advocate for a universal, comprehensive single-payer government system of healthcare in the United States. Since 1987, PNHP has sought a government-financed system that would eliminate private insurers altogether. The group is increasingly visible in the health policy world; with more than 15,000 members nationwide, it has rallied on the steps of the capitol, published papers in journals, and has lobbied Congress.

For PNHP, the reason that the Massachusetts reforms do not work is not because the reforms interfere with the health insurance market, but because they do not interfere enough. The state reform has failed, they argue, because it leaves too much of the private system in tact. Until residents are stripped of the ability to purchase coverage from private insurers, state agencies like Commonwealth Care cannot generate sufficient "administrative savings" -- the magical ingredient in the group's Medicare-for-all vision that will allegedly lower the cost of healthcare and make additional entitlements possible.

In effect, PNHP denounces the Massachusetts reform in order to throw its support behind a much bigger goal: the United States National Health Care Act (H.R. 676). This act, which has already been introduced and referred to committee for review, would provide universal coverage under a single payer (the government) and promise all individuals the "best quality standard of care" for everything ranging from primary care and prevention to prescription drugs, mental health services, dental services, chiropractic services, podiatric care, and more. According to the bill, this would all be made available for "free" -- no co-payments, deductibles, or coinsurance required.[2]

In short, the approach that PNHP, the California Nurses Association, Healthcare for All, the American Medical Students Association, and dozens of other groups employ is: if one big dose of government doesn't work, try a bigger dose.

Combined with the recent statements by President Obama that healthcare reform "cannot wait ... and will not wait another year," it is becoming clear just how dangerous a time it is for those who value individual rights. Government payment for medical services -- regardless of whether state or federal -- is neither a moral nor practical solution to the problems we face in healthcare. But is anyone in the mainstream media arguing that point? Activists have no right to require the young to sacrifice the old, the healthy to sick, or the productive to the poor. But is anyone in Congress about to defend those convictions?

Contrary to what big-government activists maintain, market forces do work in healthcare. Insurance works -- when policies are based on coverage that consumers actually want and when premiums are tied to actual risk profiles. New technologies lead to lower costs -- when reimbursement rates reflect real prices. And uninsured individuals are not a menace to others -- when providers are not forced to provide charity care and when states do not pick up the tab. Real markets feature competitors who are free to compete and consumers who are free to be discriminating in what they buy.[3]

Massachusetts has not had anything resembling a free market in healthcare for decades. But the answer is not to drift even closer to disaster and institute a bigger mess at the federal level. The answer is to unshackle consumers, providers, and insurers and free the markets once and for all.

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1 "Massachusetts’ Plan: A Failed Model for Health Care Reform" Physicians for a National Health Plan, February 18 2009

2 The United States National Health Care Act, H.R. 676 [http://www.pnhp.org/docs/nhi_bill_final1.pdf] Accessed February 27 2009

3 This is a careful improvement on a point made in Herzlinger, R. "Creating a Real Healthcare Market", Boston Globe, February 18 2009, a piece that unfortunately cedes ground to the antitrust camp.

About FIRM

America was founded on the principles of freedom and individual rights. Applied to medicine, the law must respect the individual rights of doctors and other providers, allowing them the freedom to practice medicine. This includes the right to choose their patients, to determine the best treatment for their patients, and to bill their patients accordingly. In the same manner, the law must respect the individual rights of patients, allowing them the freedom to seek out the best doctors and treatment they can afford.

Freedom and Individual Rights in Medicine (FIRM) promotes the philosophy of individual rights, personal responsibility, and free market economics in health care. FIRM holds that the only moral and practical way to obtain medical care is that of individuals choosing and paying for their own medical care in a capitalist free market. Federal and state regulations and entitlements, we maintain, are the two most important factors in driving up medical costs. They have created the crisis we face today.

Freedom and Individual Rights in Medicine was founded by Lin Zinser and Paul Hsieh, MD in 2007. It is now managed by Paul Hsieh, MD.